COVID vaccine update

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AO Sig
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Re: COVID vaccine update

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https://blogs.sciencemag.org/pipeline/a ... at-happens

I got a link to an article that gives some history and information on these new mRNA vaccines; they are really different than the vaccines that have used various "antigens" that Edward Jenner first brought us. Those of you with some science in your background should understand at least part of what the author writes (no, this is not a slight at anyone who has problems understanding it). I think it is really cool science; I also think it will end up being something that will have lots of applications in the future. For instance, it could lead to new ways to shut down cancers or other inflammatory diseases. If there is a certain protein found to trigger some chronic disease, the mRNA could be given to remove that triggering protein.

I did see another article suggesting that the Moderna vaccine will lead to immunity to at least some of the mutant strains, although it might not be as potent as to the original virus. Pfizer helps against the UK strain; have not seen anything about the South Africa strain and the Brazilian one that just popped up. Will add more as I come across it.
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TUPF
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Re: COVID vaccine update

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AO Sig, just yesterday the UK came out recommending against the Moderna or Pfizer vaccines for use in pregnant women. In light of the mRNA science can you share any insights why?

I did read the linked paper, BTW--fascinating! I too think it would be cool to actually see the light marker like the author's spouse said!
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Re: COVID vaccine update

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TUPF wrote: Thu Jan 28, 2021 7:41 am AO Sig, just yesterday the UK came out recommending against the Moderna or Pfizer vaccines for use in pregnant women.
That was literally the first thing I thought about when I heard how these new vaccines work 6 months ago, was effects on children born to parents who had it. It doesn't affect me (not having more kids) and I plan on being vaccinated, but the big unknown to me (and the only thing that makes me skeptical of the shot) is this. When you go messing with the very core of what makes us tick, and then a child is produced from "modified people", will any ill results occur? And who is willing to be the guinea pig for that, knowing that the stakes are literally the life of a child to (presumably) parents who'd like a healthy child?
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Re: COVID vaccine update

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I suspect that the recommendations for pregnant women not to get it is due to the fact that they have had no studies involving pregnant women; I am not sure that they have shown that the mRNA gets across the placental barrier, but they might do this on the basis of not giving any woman anything during their pregnancy. In med school we got to see lovely pictures of children born to moms given thalidomide to reduce nausea and vomiting; the drug had been tested on several animals without any problem, but caused severe limb abnormalities in humans.

When I did Ob rotations, I was told that the only medications allowed were tylenol, antacids, benadryl, heparin, penicillin, and that was about it. Today I was told that a lupus patient we have was told to stop plaquenil by her OB (yes, that same one Trump touted). She then went to a high-risk OB who rightly told her to get back on that medication immediately, because is it shown to improve pregnancy outcomes in mothers with lupus. There are still a litany of medications we don't use; medications now get a pregnancy and lactation safety grade, so such information is more readily available.

Will look into trying to see if there is a reason; I have heard of several pregnant hospital employees locally who have had the vaccine without problems.
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PeteRasche
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Re: COVID vaccine update

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I know I'm not the only one who now has a Billy Joel song stuck in his head after reading AO's post above...
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Re: COVID vaccine update

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Thanks, AO Sig. The database on pregnancy and COVID vaccines is probably highly limited to those who were trial participants or recently vaccinated and did not yet know they were pregnant. Nevertheless if you learn anything please share. As the vaccine is rolled out to healthy women of child bearing age it's going to become a bigger issue.
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Re: COVID vaccine update

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PeteRasche wrote: Thu Jan 28, 2021 3:18 pm I know I'm not the only one who now has a Billy Joel song stuck in his head after reading AO's post above...
Hey Pete, did you know that Billy Joel performed twice at Tulane? He did two shows about a year apart; the second was just as "The Stranger" came out; the first I think was with the "Streetlife Serenader" album. I went to both concerts as an undergrad; incredible concerts.
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Re: COVID vaccine update

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When I first moved to Baton Rouge in the early 70's, we went to a Beach Boys concert in the then new Maravich center. There was a piano player who did the warm-up act and we all thought he did a great job, especially with a new song called "Piano Man". That was my first introduction to Billy Joel.
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Re: COVID vaccine update

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Sorry to threadjack this discussion, but I have seen some data on two vaccines that are still in development.

First, the Johnson and Johnson data has been released; it had 77% protection against severe COVID in U.S studies; it was a full 20% less effective in South Africa, felt to be related to it's not being as good against the South Africa mutation that has started to be seen in the U.S. It is a bit more easily transmitted, not sure if any more aggressive in terms of severity of disease. For those of you who are scientific wonks, they are giving people an adenovirus that contains the COVID spike protein. This data is on a single dose regimen; I would not be surprised if they did a "booster dose" trial to see if they can increase coverage. The moderna and pfizer reached only about 50-60% coverage with the single dose, which is why they tried the two dose regimen, which is 95% effective.

The advantage of the J and J is that it is planned to be a single dose, and does not need to be kept in the deep freeze like the pfizer, which makes it easier to transport. The effectiveness puts it a bit better than the flu shot does.

The second vaccine comes from a company called novavax; they have a 2 dose regimen that has reached almost 90% effectiveness in British studies against the UK variant (it reached 95% against the original virus). It does not need to be frozen, just refrigerated.

I have not seen anything new on the Astra Zeneca vaccine; with the new stuff coming out I would hope that they will try to "keep up with the Joneses" and release info on theirs.

I have been in contact with a scientific liaison with Pfizer to find out special questions; might be able to set up a zoom meeting Wednesday or Thursday. That is all. Oh, BTW- Billy Joel opened one of his concerts at Tulane with "I've seen the lights go out on Broadway;" great staging and lighting.
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Re: COVID vaccine update

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Thanks for the info, AO.

My only Tulane-related memory of Billy Joel was my radio alarm clock going off at 4:45 am one Fall morning of my freshman year for basketball weight-lifting/conditioning, and the DJ saying, "here's a brand new song by Billy Joel that's an interesting bit of a history lesson", followed by the first time I ever heard the song I referenced above that started this whole threadjack... I laid there, waking up, trying to figure out how many of the references in the song I knew about, and how clever the song was to rhyme so many historical events and names while grouping them chronologically by verse.
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Re: COVID vaccine update

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Read some bad news this morning. The monoclonal antibodies treatment engineered against the original COVID-19 strain (what was used for 45 at Walter Reed) has shown to be ineffective against the South African and Brazilian variants. Still too early to tell for treatment of the UK strain since clinical trials are still in progress. And so it goes.
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Re: COVID vaccine update

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I had my second Pfizer vaccine over the weekend. Five hours or so later I began getting flu like symptoms especially body aches and fever. I took Tylenol. 48 hours after the vaccine I felt fine.

My niece who is an ER MD in New York City had both doses of the Pfizer vaccine in December. She gave birth to her son in early January.
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Re: COVID vaccine update

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I get my first dose on Thursday, will update after that occurs.
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Re: COVID vaccine update

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I had my first shot three weeks ago...Moderna...no problems. I get the second on next Wednesday. Thanks for the Tylenol tip. I will take it after my second shot and give a report.
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Re: COVID vaccine update

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I had a chat with a scientific liaison from Pfizer today; lots of discussion about the vaccines, etc. Lots of explanations about things.

First, there were a few things I learned about the vaccine- I asked about the 5% that got the infection after the 2 doses; was told that the data was not published, but a high number of the placebo group ended up in the hospital, while the ones that were in the vaccine group and were deemed "serious" really weren't too bad off. My feeling is that the vaccines might protect completely, but if one gets the virus, it will probably be milder.

Second- I asked about my patients who are on nasty medications; they are going to do a study on the vaccines in patients with rheumatoid arthritis taking two of the advanced medications to see how they work. As people on these medications and with these diseases often need two flu shots for adequate coverage, I told him that they should include a three-dose regimen; hope they listen.

I did learn a little about the tylenol and ibuprofen debate with the vaccines; I learned that the people saying no to these are basing it on reports last March that raised concern that people taking ibuprofen were sicker with COVID, with the recommendation to avoid these meds a transference from this. apparently it might not be too bad to take something to reduce the side effects.

I asked about whether there was a correlation between side effects after the second dose and effectiveness of the vaccine; he said that they think that younger people with more robust immune systems seem to be more likely to have side effects (which is why I only had a little arm pain, thus suggesting I have reached "old f@rt" status). There has been debate about pregnant women getting the vaccines; apparently the WHO said no in Europe, but ACOG (the ob-gyn people in the U.S) said yes. The consensus now is that pregnant women should be immunized.

My daughter wanted to know that if the rumors that Pfizer went to "Dippin' Dots" to get info on transporting the vaccines. He only told me that the reason it is transported in the very cold transport is that the mRNA is very easy to degrade, so that the cold temps keep the mRNA intact until it is injected. They are trying to find different ways to transport the vaccine that improves its stability.

I asked about the variant strains and pfizer; he says that it might not protect as well, and that some companies are looking at possibly adjusting the mRNA to improve coverage toward other strains. He could not tell me if annual vaccine boosters will be needed; the studies are two year trials and once the 1 year data is obtained this fall they might be able to tell us if we need a third dose 1 year from now. He did tell me that the mRNA vaccines will stimulate both the Humoral (as in antibody) immunity as well as Cellular immunity (as in cytotoxic T cells for those of you who are wonky)

In other papers I read- Astra Zeneca's vaccine has about 75% protection against infection; one nice thing they showed was that it might reduce transmission, which means if you get infected after getting the dose, you might be less likely to give it to others around you. this suggests it reduces spread, which is important in society.

I have not heard when Astra Zeneca and johnson and Johnson are going to submit their vaccines to the FDA; based on the fact that they are publishing their data (these two are more like the older vaccines, so might not be as good in the cellular immunity side) I would not be surprised if one or both were submitted by the end of this month.

finally, I wanted to share a conversation I had with a patient today (will hide the patient's name, sex and diagnosis to comply with HIPAA). They said that they had COVID, and that they were helping to care for an elderly parent. Because they were being cautious around their parent, including wearing masks with any close contact, their parent did not come down with the virus despite their being very close the day before they became symptomatic (which would mean they could have easily passed it on). Their message supports my thought about the masks- they protect other people from you better than their protecting you from other people. That might be why Fauci is touting wearing the double masks; the single mask might not protect you from other people very well. There are studies galore looking at mask effectiveness; I fully expect to see three or four studies with conflicting results.

Sorry about the length; the 30 minute call was full of interesting information, probably missed a few things.
Last edited by AO Sig on Thu Feb 04, 2021 6:51 am, edited 1 time in total.
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Re: COVID vaccine update

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My mom got her second shot Friday. Said she was really tired, went to bed, and was fine by Saturday. My dad's second shot is set for Ash Wednesday. My mother-in-law is scheduled for her second shot on Feb 10. Will add their anecdotes to this discussion when the time comes.
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Re: COVID vaccine update

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doc wrote: Tue Feb 02, 2021 9:30 pm I had my second Pfizer vaccine over the weekend. Five hours or so later I began getting flu like symptoms especially body aches and fever. I took Tylenol. 48 hours after the vaccine I felt fine.

My niece who is an ER MD in New York City had both doses of the Pfizer vaccine in December. She gave birth to her son in early January.
Thanks, doc. My wife and I get our second dose in a couple weeks. No problems with first one. That would worry me if suddenly I felt sickly.
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Re: COVID vaccine update

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AO Sig wrote: Wed Feb 03, 2021 11:51 pm My daughter wanted to know that if the rumors that Pfizer went to "Dippin' Dots" to get info on transporting the vaccines. He only told me that the reason it is transported in the very cold transport is that the mRNA is very easy to degrade, so that the cold temps keep the mRNA intact until it is injected. They are trying to find different ways to transport the vaccine that improves its stability.
So....yes?
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Re: COVID vaccine update

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ml wave wrote: Thu Feb 04, 2021 12:10 pm
AO Sig wrote: Wed Feb 03, 2021 11:51 pm My daughter wanted to know that if the rumors that Pfizer went to "Dippin' Dots" to get info on transporting the vaccines. He only told me that the reason it is transported in the very cold transport is that the mRNA is very easy to degrade, so that the cold temps keep the mRNA intact until it is injected. They are trying to find different ways to transport the vaccine that improves its stability.
So....yes?
Whatever works! This should be an Operation Dynamo where the Brits evacuated Dunkirk in any ship/boat/pontoon available. We are losing a 9/11 death toll+, every day.
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Re: COVID vaccine update

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TUPF wrote: Thu Feb 04, 2021 12:23 pm
ml wave wrote: Thu Feb 04, 2021 12:10 pm
AO Sig wrote: Wed Feb 03, 2021 11:51 pm My daughter wanted to know that if the rumors that Pfizer went to "Dippin' Dots" to get info on transporting the vaccines. He only told me that the reason it is transported in the very cold transport is that the mRNA is very easy to degrade, so that the cold temps keep the mRNA intact until it is injected. They are trying to find different ways to transport the vaccine that improves its stability.
So....yes?
Whatever works! This should be an Operation Dynamo where the Brits evacuated Dunkirk in any ship/boat/pontoon available. We are losing a 9/11 death toll+, every day.
Sure, whatever works, but <answerthequestion.gif>
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Re: COVID vaccine update

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ml wave wrote: Thu Feb 04, 2021 12:37 pm
TUPF wrote: Thu Feb 04, 2021 12:23 pm
ml wave wrote: Thu Feb 04, 2021 12:10 pm
AO Sig wrote: Wed Feb 03, 2021 11:51 pm My daughter wanted to know that if the rumors that Pfizer went to "Dippin' Dots" to get info on transporting the vaccines. He only told me that the reason it is transported in the very cold transport is that the mRNA is very easy to degrade, so that the cold temps keep the mRNA intact until it is injected. They are trying to find different ways to transport the vaccine that improves its stability.
So....yes?
Whatever works! This should be an Operation Dynamo where the Brits evacuated Dunkirk in any ship/boat/pontoon available. We are losing a 9/11 death toll+, every day.
Sure, whatever works, but <answerthequestion.gif>
You can Google as well as I just did. Lots of articles before Christmas on Dippin Dots supply chain lessons but nothing I could see of actual implementation since. I'm sure AO Sig would share if he had some inside scoop.
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Re: COVID vaccine update

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TUPF wrote: Thu Feb 04, 2021 12:46 pm
ml wave wrote: Thu Feb 04, 2021 12:37 pm
TUPF wrote: Thu Feb 04, 2021 12:23 pm
ml wave wrote: Thu Feb 04, 2021 12:10 pm
AO Sig wrote: Wed Feb 03, 2021 11:51 pm My daughter wanted to know that if the rumors that Pfizer went to "Dippin' Dots" to get info on transporting the vaccines. He only told me that the reason it is transported in the very cold transport is that the mRNA is very easy to degrade, so that the cold temps keep the mRNA intact until it is injected. They are trying to find different ways to transport the vaccine that improves its stability.
So....yes?
Whatever works! This should be an Operation Dynamo where the Brits evacuated Dunkirk in any ship/boat/pontoon available. We are losing a 9/11 death toll+, every day.
Sure, whatever works, but <answerthequestion.gif>
You can Google as well as I just did. Lots of articles before Christmas on Dippin Dots supply chain lessons but nothing I could see of actual implementation since. I'm sure AO Sig would share if he had some inside scoop.
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Re: COVID vaccine update

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TUPF wrote: Thu Feb 04, 2021 12:46 pm
ml wave wrote: Thu Feb 04, 2021 12:37 pm
TUPF wrote: Thu Feb 04, 2021 12:23 pm
ml wave wrote: Thu Feb 04, 2021 12:10 pm
AO Sig wrote: Wed Feb 03, 2021 11:51 pm My daughter wanted to know that if the rumors that Pfizer went to "Dippin' Dots" to get info on transporting the vaccines. He only told me that the reason it is transported in the very cold transport is that the mRNA is very easy to degrade, so that the cold temps keep the mRNA intact until it is injected. They are trying to find different ways to transport the vaccine that improves its stability.
So....yes?
Whatever works! This should be an Operation Dynamo where the Brits evacuated Dunkirk in any ship/boat/pontoon available. We are losing a 9/11 death toll+, every day.
Sure, whatever works, but <answerthequestion.gif>
You can Google as well as I just did. Lots of articles before Christmas on Dippin Dots supply chain lessons but nothing I could see of actual implementation since. I'm sure AO Sig would share if he had some inside scoop.
Inside scoop. Dippin Dots. Well done. :mrgreen:
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Re: COVID vaccine update

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PeteRasche wrote: Thu Feb 04, 2021 8:55 pm
TUPF wrote: Thu Feb 04, 2021 12:46 pm
ml wave wrote: Thu Feb 04, 2021 12:37 pm
TUPF wrote: Thu Feb 04, 2021 12:23 pm
ml wave wrote: Thu Feb 04, 2021 12:10 pm
AO Sig wrote: Wed Feb 03, 2021 11:51 pm My daughter wanted to know that if the rumors that Pfizer went to "Dippin' Dots" to get info on transporting the vaccines. He only told me that the reason it is transported in the very cold transport is that the mRNA is very easy to degrade, so that the cold temps keep the mRNA intact until it is injected. They are trying to find different ways to transport the vaccine that improves its stability.
So....yes?
Whatever works! This should be an Operation Dynamo where the Brits evacuated Dunkirk in any ship/boat/pontoon available. We are losing a 9/11 death toll+, every day.
Sure, whatever works, but <answerthequestion.gif>
You can Google as well as I just did. Lots of articles before Christmas on Dippin Dots supply chain lessons but nothing I could see of actual implementation since. I'm sure AO Sig would share if he had some inside scoop.
Inside scoop. Dippin Dots. Well done. :mrgreen:
Well done, grasshoppa.
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Re: COVID vaccine update

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Well, one of my predictions just came true; Johnson and johnson has announced that they have submitted an emergency use application to the FDA for their vaccine. The FDA will have their people go through the data, do the calculations themselves, review the side effects and then decide on approval. Unless there is something nefarious in the data I would expect it to be approved in the next 2-3 weeks.

This vaccine is one dose, which will make it more palatable to a lot of needle-phobic people. Its effectiveness is not as good as the Moderna and Pfizer, but if you look at the effectiveness of a single dose, it actually does better (which is why Pfizer and Moderna use a "two dose" protocol to reach the 95% effectiveness).

In the cases of people who get the infection despite getting the J and J vaccine, it is entirely possible they have a milder case than they would have had without the vaccine. Since J and J have done this, Astra-Zeneca will either "fish or cut bait." Unless there is some problem with their vaccine, expect its application to be dropped in the next week or two.
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